Project Summary: Limited available data indicate that African American men are at greater risk for chronic pancreatitis (CP), a chronic inflammatory disease, than are Caucasians. In 2006, we completed enrollment of 1000 patients with CP (n=540) or recurrent acute pancreatitis (n=460) and 695 control subjects through the North American Pancreatitis Study 2 (NAPS2). However, because patients were enrolled consecutively with no special effort to solicit minority referrals, NAPS2 enrolled 58 Black patients with CP, which was an insufficient sample size for subset analyses. Given the higher risk among African American males in particular, we propose an ancillary study (NAPS2-AS) to enroll 250 African Americans with CP and 250 age- and sex-matched controls. We will secure the same robust dataset as for NAPS2, including environmental, lifestyle, clinical, and imaging data with a linked biorepository (serum and DNA). We will also perform preliminary targeted genotyping to screen for known variations in major susceptibility genes for CP in Whites and to sequence the CFTR gene in this African American cohort. These initial genotyping efforts will support analysis of gene- environment interactions to identify specific risk factors and optimal treatment options in African Americans and permit comparisons with the NAPS2 dataset. The study will use a multicenter observational design. To support the standardized and orderly collection, transmission, organization, and maintenance of these valuable data, we will enlist the services of the Epidemiology Data Center at the University of Pittsburgh Graduate School of Public Health, which has 28 years experience managing large national and international multisite clinical research, as a coordinating center for all NAPS2-related studies (NAPS2, NAPS2-AS, NAPS2- continuation & validation study or NAPS2-CV). PUBLIC HEALTH RELEVANCE: This genetic epidemiological study will determine whether environmental risk, such as alcohol use and smoking, for chronic pancreatitis is the same in African American patients and Caucasians, and whether the known variations in major susceptibility genes that predict increased risk for disease found in Caucasians also occur in African Americans.